Prognosis of isolated congenital diaphragmatic hernia using lung‐area‐to‐head‐circumference ratio: variability across centers in a national perinatal network

ABSTRACT Objective Congenital diaphragmatic hernia (CDH) is a severe anomaly. The observed‐to‐expected lung‐area‐to‐head‐circumference ratio (o/e‐LHR) has been shown to provide a useful prediction of subsequent survival of fetuses with CDH in referral centers with expertise and a large caseload. How...

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Published in:Ultrasound in obstetrics & gynecology 2018-02, Vol.51 (2), p.208-213
Main Authors: Senat, M.‐V., Bouchghoul, H., Stirnemann, J., Vaast, P., Boubnova, J., Begue, L., Carricaburu, E., Sartor, A., Jani, J., Benachi, A., Bouyer, J.
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Language:English
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Summary:ABSTRACT Objective Congenital diaphragmatic hernia (CDH) is a severe anomaly. The observed‐to‐expected lung‐area‐to‐head‐circumference ratio (o/e‐LHR) has been shown to provide a useful prediction of subsequent survival of fetuses with CDH in referral centers with expertise and a large caseload. However, the accuracy of o/e‐LHR measurements in general fetal medicine units with less expertise is not well known. The aim of this study was to evaluate the capacity of o/e‐LHR to provide a useful prediction of mortality of fetuses with CDH when the measurement is performed in fetal medicine units with different levels of expertise. Methods Between January 2008 and November 2013, 305 live births with expectantly managed left‐sided isolated CDH were recorded in the database of the French National Center for Rare Diseases (31 centers) and followed up after birth. Centers were grouped into two categories according to their mean annual CDH caseload over the study period: large centers with an average of ≥ 14 cases and smaller centers with
ISSN:0960-7692
1469-0705
DOI:10.1002/uog.17463